Primary Aortic Epithelioid Angiosarcomas With Metastatic Disease Detected by 18F-FDG PET/CT

Abstract

Epithelioid angiosarcoma in the aortic arch with metastatic disease is extremely rare. We report a case of 63-year-old man with suspected bone metastases who underwent 18 F-FDG PET/CT for seeking the potential primary tumor. PET/CT demonstrated intense FDG uptake in the aortic arch with multiple FDG-avid lesions involving the lung, lymph nodes, and bones. Finally, the diagnosis of primary aortic epithelioid angiosarcomas with metastatic disease was confirmed.

FDG-Avid Periprosthetic Particle Disease Mimicking Osteosarcoma Recurrence

“…PET/CT enables fast and exact full-body evaluation, and the data acquisition is not affected by metal implants. 12,13 This current case activity was mainly in the muscles, which is totally different from the periprosthetic FDG activity without mass shown in the loosening or infection. 14,15 Unfortunately, it is difficult for FDG PET/CT to distinguish between particle disease and neoplasm recurrence in the current case, and biopsy is required to establish the final diagnosis.…”

“…Unlike previously reported cases, the current case presented with obvious soft tissue masses without osteolytic bone destruction due to no residual bone tissue. PET/CT enables fast and exact full-body evaluation, and the data acquisition is not affected by metal implants 12,13. This current case activity was mainly in the muscles, which is totally different from the periprosthetic FDG activity without mass shown in the loosening or infection 14,15.…”

“…This case highlights that particle disease should be included in the differential diagnosis of high FDG uptake around the prosthesis on PET/CT images. 12,13,[16][17][18] As the prevalence of osteosarcoma and the number of prosthetics increase, proper recognition by PET/CT will help the management of prosthetics. 4…”

18F-FDG PET/CT Imaging of Prostatic Epithelioid Hemangioendothelioma

“…10 PET/CT imaging has proven to be a valuable tool for diagnosing and staging epithelioid hemangioendothelioma as well as evaluating treatment efficacy. 11,12 Our case highlights that epithelioid hemangioendothelioma of the prostate should be considered for differential diagnosis in prostate tumors with intense FDG uptake.…”

“…Epithelioid hemangioendothelioma of prostate is even rarer, and its potential differentials include prostatic adenocarcinoma, 3 prostate carcinosarcoma, 4 metastasis, 5 lymphoma, 6 malignant fibrous histiocytoma, 7 synovial sarcoma, 8 alveolar rhabdomyosarcoma, 9 and extraskeletal Ewing sarcoma 10 . PET/CT imaging has proven to be a valuable tool for diagnosing and staging epithelioid hemangioendothelioma as well as evaluating treatment efficacy 11,12 . Our case highlights that epithelioid hemangioendothelioma of the prostate should be considered for differential diagnosis in prostate tumors with intense FDG uptake.…”